REACHING BOYS AND REACHING BOYS AND YOUNG MENYOUNG MEN

WITH WITH STI PREVENTION STI PREVENTION

MESSAGESMESSAGES

Wayne V. PawlowskiWayne V. Pawlowski, , LICSW, LICSW, AASECT Certified Sexuality EducatorAASECT Certified Sexuality Educator

National Chlamydia CoalitionNational Chlamydia CoalitionFebruary 20, 2013February 20, 2013

BE AWARE:BE AWARE:I Am Going To Be I Am Going To Be

Speaking In Generalities!Speaking In Generalities!

► So, when I say “WE,” I do NOT mean So, when I say “WE,” I do NOT mean every one of us individually…every one of us individually…

► I I dodo mean “OUR FIELD” mean “OUR FIELD” in generalin general: : reproductive health, family planning, reproductive health, family planning, and STI prevention.and STI prevention.

► So, don’t take my comments So, don’t take my comments “personally” (individually)…but, “personally” (individually)…but,

►DO take them as a view…a DO take them as a view…a perception… of our field/our work perception… of our field/our work world.world.

And remember,And remember,

It is the It is the perceptionperception that that informs/influences how guys informs/influences how guys

view/see us.view/see us.

And how they will respond to our And how they will respond to our outreach/messages.outreach/messages.

Fools Rush In Fools Rush In Where Wise Men Fear To Where Wise Men Fear To

Go!!!Go!!!

Five Incredible Five Incredible Sources Of Sources Of

Information/InsightInformation/InsightAbout Boys and Young Men:About Boys and Young Men:► MARS Program, Benton County, ORMARS Program, Benton County, OR

MMale ale AAdvocates for dvocates for RResponsible esponsible SSexualityexuality Brian Dekker and Andy ChuinardBrian Dekker and Andy Chuinard

► And,And,► William Pollock: Author of William Pollock: Author of Real Boys and Real Real Boys and Real

Boys VoicesBoys Voices► And, ABC’s And, ABC’s 20-2020-20: : The Secret Life of Boys The Secret Life of Boys

(video),(video),► And,And,► Michael Gurian: Author of the Michael Gurian: Author of the Wonder of BoysWonder of Boys► And,And,► Michael Thompson: Author ofMichael Thompson: Author of the book and the book and

videovideo Raising Cain Raising Cain

Plus #6: My own 30 years Plus #6: My own 30 years of experience in of experience in

reproductive health/reproductive health/family planning/family planning/

STI-HIV prevention/ STI-HIV prevention/ sexuality education sexuality education working with both working with both

men and women/boys and men and women/boys and girls.girls.

Typically The QuestionTypically The Question, , “How Can We More Effectively “How Can We More Effectively Reach Boys and Young Men?” Reach Boys and Young Men?”

Means:Means:

►What do we need to know about them… What do we need to know about them… ► So we can get them into our So we can get them into our

clinics/health centers/programs…clinics/health centers/programs…► So we can get them tested (and So we can get them tested (and

treated)…treated)…

So we can get them to stop infecting So we can get them to stop infecting their partners and behaving badly.their partners and behaving badly.

I Suggest To You What That I Suggest To You What That Means Is: Means Is:

►We really don’t like guys very much.We really don’t like guys very much.►We see them as irresponsible We see them as irresponsible

“foreigners” with whom we and our “foreigners” with whom we and our female patients/clients cannot female patients/clients cannot communicate.communicate.

►We really only want to “serve” them We really only want to “serve” them as a way of protecting their female as a way of protecting their female partners.partners.

►We really aren’t all that interested in We really aren’t all that interested in THEM and THEIR concerns, needs THEM and THEIR concerns, needs and/or issues.and/or issues.

► And, at some level, boys/young men And, at some level, boys/young men know and/or feel all of this.know and/or feel all of this.

Lets start with what I mean Lets start with what I mean

when I say:when I say:

““We don’t like guys very much.”We don’t like guys very much.”Or,Or,

To put it another way:To put it another way:Lets look at how we Lets look at how we REALLYREALLY feel feel

about males? about males? What are our real attitudes about What are our real attitudes about

them?them?

When I “Listen To” Our Field, When I “Listen To” Our Field, What I Hear Is That We Believe What I Hear Is That We Believe

Men Are:Men Are: ►Uninterested in STI prevention and Uninterested in STI prevention and

family planning,family planning,►Unconcerned about the things Unconcerned about the things

they “should” be concerned about,they “should” be concerned about,►Uninvolved,Uninvolved,►Irresponsible,Irresponsible,►Unwilling and uninterested in Unwilling and uninterested in

communicating about communicating about relationships,relationships,

►UNTRUSTWORTHY!!!!!!!!!!!!!!!UNTRUSTWORTHY!!!!!!!!!!!!!!!

If we are going to have If we are going to have any success in reaching any success in reaching

out to out to boys and young men, boys and young men, we will HAVE TO deal we will HAVE TO deal

withwith these attitudes and these attitudes and

beliefs.beliefs.We are going to have to reframe our We are going to have to reframe our thinking and begin to see boys and thinking and begin to see boys and young men in new/different ways.young men in new/different ways.

We Are Going To Have To Go We Are Going To Have To Go With The Premise (Assume) With The Premise (Assume)

That That Most Of Them Really Are: Most Of Them Really Are:

► Interested !Interested !► Concerned !!Concerned !!►Responsible !!!Responsible !!!►And, if they appear not to be, they really And, if they appear not to be, they really

do want to be !!!!do want to be !!!!► Involved…even if not in the way(s) Involved…even if not in the way(s) wewe

think they should be !!!!!think they should be !!!!!►And, And, ► TRUSTWORTHY !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!TRUSTWORTHY !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

!!!!!!!!!!

And, We Need To Recognize And, We Need To Recognize That Boys And Young Men:That Boys And Young Men:

► Are curious.Are curious.► Want to know about STIs (and contraception).Want to know about STIs (and contraception).► Do Do not not want to infect their partners.want to infect their partners.► Want to be good/better partners.Want to be good/better partners.► Want to know how to talk with their partners.Want to know how to talk with their partners.► Want to communicate caring and honest Want to communicate caring and honest

concerns.concerns.► Do Do notnot want to be insensitive. want to be insensitive.► Want to be good lovers.Want to be good lovers.► Want to be partners/allies in STI prevention.Want to be partners/allies in STI prevention.

BUT…BUT…► They simply may not know how.They simply may not know how.

► American male enculturation (how to “be a American male enculturation (how to “be a man”) gets in the way of their being in touch man”) gets in the way of their being in touch with feelings and/or being able to express with feelings and/or being able to express feelings.feelings.

► They are likely nervous about what they do They are likely nervous about what they do not know…in part because they are not know…in part because they are supposed supposed to know everything.to know everything.

► They fear that if they try to do/be all of these They fear that if they try to do/be all of these things that they will be judged… and not things that they will be judged… and not kindly.kindly.

ThisThis Cathy Cathy Cartoon Sums It All Cartoon Sums It All Up!Up!

Our Negative Attitudes/Beliefs Our Negative Attitudes/Beliefs About Males Show Up In:About Males Show Up In:

► Jokes,Jokes,►Our expectations of them (what we Our expectations of them (what we

expect is what we see/get), expect is what we see/get), ►Men and EC,Men and EC,► Posters that we hang in our clinics, andPosters that we hang in our clinics, and►Ad images/messages that target Ad images/messages that target

women.women.

POSTERSPOSTERSand and

Advertising Advertising MessagesMessages

What do I mean when I What do I mean when I say:say:

We only want to “serve” males so We only want to “serve” males so we can protect their partners;we can protect their partners;

and,and,

We aren’t really interested in them We aren’t really interested in them and/or their concerns, needs and and/or their concerns, needs and

issues.issues.

In reproductive health In reproductive health settings, women have settings, women have traditionally been our traditionally been our

primary clients and our primary clients and our primary concern. primary concern.

Therefore, it is not unusual Therefore, it is not unusual for male concerns to be for male concerns to be

responded to through our responded to through our concerns for women rather concerns for women rather than directly through the than directly through the

concerns of men.concerns of men.

According To Michael According To Michael GurianGurian

The Top 5 Concerns Of The Top 5 Concerns Of Adolescent Males Are:Adolescent Males Are:

1.1. Am I normal?Am I normal?2.2. Am I attractive?Am I attractive?3.3. HomophobiaHomophobia

1.1. Fear being gayFear being gay2.2. Fear appearing to be gayFear appearing to be gay

4.4. Sexual ProwessSexual Prowess5.5. Penis sizePenis size

According To The MARS According To The MARS ProgramProgram

The most common question male The most common question male college freshmen asked the MARS college freshmen asked the MARS

staff was…staff was…

How many guys are having sex?How many guys are having sex?

What’s behind that question?What’s behind that question?

Am I normal?Am I normal?

Am I like other guys?Am I like other guys?

Am I a “real man?”Am I a “real man?”

How Many Of These Concerns How Many Of These Concerns Are We Prepared To Address…Are We Prepared To Address…

Or Or WANTWANT To Address? To Address?

► If these are the top concerns of young men, why If these are the top concerns of young men, why are we not asking our male clients about them? are we not asking our male clients about them?

► The young men who talked with MARS staff, The young men who talked with MARS staff, asked about sexual prowess and being normal asked about sexual prowess and being normal when they asked how many guys are having sex. when they asked how many guys are having sex.

► Why did they ask the MARS staff and why don’t Why did they ask the MARS staff and why don’t wewe hear these questions (and generally we hear these questions (and generally we don’t)? don’t)?

► What are we communicating that suggests we What are we communicating that suggests we are not approachable about these concerns?are not approachable about these concerns?

So let’s look at some of So let’s look at some of these these

questions/issues/concerns questions/issues/concerns and see how and see how

we tend to respond we tend to respond as a field.as a field.

Let’s start with Gurian’s Let’s start with Gurian’s 5 5thth male concern: male concern:

penis sizepenis size..

Regarding Penis Size:Regarding Penis Size:Do You Know The Do You Know The

Average Size Of An Erect Average Size Of An Erect Male Penis?Male Penis?

The average erect male penis is The average erect male penis is about the same size (length) as a about the same size (length) as a

Starbucks Grande Coffee!!!Starbucks Grande Coffee!!!

BUT, not as thick.BUT, not as thick.

……a Starbucks a Starbucks GrandeGrande Coffee!!!!!Coffee!!!!!

(…but not as thick)(…but not as thick)

And that size isAnd that size is5.877 inches.5.877 inches.

The average “range” The average “range”

seems to be between seems to be between

5.1 and 6.2 inches5.1 and 6.2 inches

And Penis Size Relates To And Penis Size Relates To Condom Use And Condom Use And

Condom Use Education Condom Use Education

►Which are DIRECTLY related to STI Which are DIRECTLY related to STI prevention.prevention.

► The Two Most Common Complains We The Two Most Common Complains We Hear From Men About Condoms Are:Hear From Men About Condoms Are:

► Too tight/too small/I’m too big;Too tight/too small/I’m too big;► Loss of feeling/don’t feel as much/like Loss of feeling/don’t feel as much/like

showering with a raincoat.showering with a raincoat.► There Are Others But These Are The There Are Others But These Are The

Most Common.Most Common.

So How Do We Tend To So How Do We Tend To Respond To These Respond To These

Complaints?Complaints?►We blow up condoms like balloons.We blow up condoms like balloons.►We pull them over our arms.We pull them over our arms.►And we say, “No one is And we say, “No one is THATTHAT big!!!” big!!!”

or, “So, is size really a problem??!!”or, “So, is size really a problem??!!”►We assume an “ego problem.”We assume an “ego problem.”

►With loss of feeling, we respond with With loss of feeling, we respond with some version of “Well, if she’s smart, some version of “Well, if she’s smart, you won’t be feeling anything if you you won’t be feeling anything if you don’t wear one!”don’t wear one!”

By Assuming “I’m Too Big” By Assuming “I’m Too Big” Is An Ego Problem We Is An Ego Problem We

Completely Miss The Point Completely Miss The Point For Most MenFor Most Men

►And, thereby we give them the And, thereby we give them the message that we really are not message that we really are not interested in them or in their interested in them or in their problems.problems.

► The best response/reply to “They The best response/reply to “They don’t fit” is,don’t fit” is,

““Tell me when you have a problem.”Tell me when you have a problem.”

►In the absence of an ego problem, In the absence of an ego problem, what we are most likely to hear is what we are most likely to hear is some versions of:some versions of:

►Can’t get the ring of the condom Can’t get the ring of the condom over the head of the penis.over the head of the penis.

►The pressure of the ring at the The pressure of the ring at the base inhibits ejaculation.base inhibits ejaculation.

If Either Of These Are A If Either Of These Are A Man’s Concern…Man’s Concern…

►Our flip, “ego problem” response is Our flip, “ego problem” response is a quick way to shut men down.a quick way to shut men down.

►And to make them believe (rightly?) And to make them believe (rightly?) that we really are not interested in that we really are not interested in knowing what is going on with them.knowing what is going on with them.

With Loss Of Feeling…With Loss Of Feeling…► It It ISIS like like showering with a raincoat! showering with a raincoat!► You You DON’TDON’T feel as much! feel as much!

But, that doesn’t mean men can’t But, that doesn’t mean men can’t or or won’t use them.won’t use them.

►We have to explore the extent of the We have to explore the extent of the problem they are having and then help problem they are having and then help them problem solve.them problem solve.

► It is one thing if he loses sensation and It is one thing if he loses sensation and takes a long time to cum.takes a long time to cum.

► It is another thing if he loses so much It is another thing if he loses so much sensation that he can’t ejaculate at all.sensation that he can’t ejaculate at all.

To Improve Condom To Improve Condom Education and Condom Use, Education and Condom Use,

We Need to:We Need to:

►Be honest, direct, clear, Be honest, direct, clear, knowledgeableknowledgeable, and HELPFUL., and HELPFUL.

►Know how to help a man “size” Know how to help a man “size” his penis for condoms.his penis for condoms.

►Know about and recommend Know about and recommend thinner condoms.thinner condoms.

And remember…And remember…

►Condoms come in a WIDE variety of Condoms come in a WIDE variety of colors, textures, sizes and flavors…..colors, textures, sizes and flavors…..

►If you are shopping for them yourself If you are shopping for them yourself for the first time, the selection for the first time, the selection can be (IS!!!) overwhelming….can be (IS!!!) overwhelming….

Remember, Appropriate Humor Remember, Appropriate Humor Can Go A Long Way In Helping Can Go A Long Way In Helping

To Talk With Men About To Talk With Men About Difficult SubjectsDifficult Subjects

► Condom manufacturers have been GREAT Condom manufacturers have been GREAT at using humor in their advertising.at using humor in their advertising.

► I have NO investments in any condom I have NO investments in any condom manufacturers!!!!!!! So, I am NOT manufacturers!!!!!!! So, I am NOT pushing any brand of condom!!!!!!pushing any brand of condom!!!!!!

► I am just sharing creative and fun I am just sharing creative and fun condom ads!!!!!! I can recommend the condom ads!!!!!! I can recommend the ads not necessarily the condoms!!!!!!ads not necessarily the condoms!!!!!!

Durex Television AdDurex Television Ad

Condom Poster Ads Condom Poster Ads and and

Print Media AdsPrint Media Ads

LASTLY:LASTLY:► Lets take a look at the cover of one of Lets take a look at the cover of one of

the best selling men’s magazines that the best selling men’s magazines that deals directly with men’s heath:deals directly with men’s heath:

►MEN’S HEALTHMEN’S HEALTH

►Note the three themes you see on each Note the three themes you see on each and every cover…the themes that get and every cover…the themes that get guys’ attention and that sell the guys’ attention and that sell the magazine.magazine.

► And, that show up on the covers of And, that show up on the covers of MOST men’ magazines…not just MOST men’ magazines…not just Men’s Men’s HealthHealth..

THE THREE THEMES?THE THREE THEMES?

SEX,SEX,

MUSCLES, MUSCLES, andand

ABS !!!ABS !!!

NOT STIs!!!!!!!!NOT STIs!!!!!!!!

SOMETHING TO THINK SOMETHING TO THINK ABOUT:ABOUT:

► If we could find a way to incorporate If we could find a way to incorporate these three themes into our outreach these three themes into our outreach to boys and young men; to boys and young men;

►and then actually address their real and then actually address their real concerns; concerns;

►my bet is they would be beating our my bet is they would be beating our doors down to get in!!!!!!doors down to get in!!!!!!

WHEW!!!!WHEW!!!!